Ana Maria Segall-Corrêa

Insegurança alimentar como indicador de iniqüidade: análise de inquérito populacional

This study aimed to analyze the association between food insecurity and certain socioeconomic and demographic variables that measure social inequality: income, schooling, race, family structure, household characteristics, and sewage conditions. A sample of 456 families in Campinas, Sao Paulo State, was interviewed using the Brazilian Food Insecurity Scale (EBIA). Family food insecurity was associated with: more children < 18 years; precarious housing; overcrowding; lack of sewage system; low income (< 2 times the minimum wage); head-of-household with no schooling; no university graduate in the family; and race (black). Directly measuring food insecurity is important for monitoring inequality, and can be used either with other socioeconomic and demographic indicators or alone to identify social vulnerability in population groups.

Psychometric properties of a modified US-household food security survey module in Campinas, Brazil

Objective:To assess the internal validity of a multiple-item measure of household food security in Brazil using statistical methods based on the single-parameter logistic (Rasch) measurement model.Subjects/Methods:Sample of the non-institutionalized civilian population living in the municipality of Campinas selected using stratified cluster sampling. Of the 1000 households randomly chosen, 847 responded to the interview. Responses to each of the 15 questions were coded into dichotomous items indicating whether the specific food-insecure condition had occurred (other than in just 1 or 2 days) during the 3 months before the survey. Scaling analyses were conducted separately as well as jointly for adult/household-related items and child-related items. Item-fit statistics were examined to determine the extent to which the items appear to measure the same underlying phenomenon, and item severity scores were compared with those of equivalent items in the US Current Population Survey.Results:Except for one item, infit statistics were within a range considered adequate (0.80–1.2), indicating a common phenomenon being measured with approximately equal discrimination. The relative severites of the items in the Campinas survey were generally similar to those of equivalent items in the US Current Population Survey. Analysis of all 15 items together indicates a higher severity level for child-related items compared with equivalent adult-related items.Conclusions:This analysis will serve as the prototype for confirming the psychometric validity of a food insecurity scale at a national level.

Conceituando e medindo segurança alimentar e nutricional

An interdisciplinary conceptual framework of food security is presented that identifies determinants at the macro-socioeconomic, regional-local, and household levels. Food insecurity is described as having consequences for health and well-being that may or may not be expressed in the form of physical-biological consequences such as underweight or nutritional deficiencies. The implications of this perspective for measurement of food security are addressed. A comparative review of indicators commonly used to assess food security is presented, with special focus on the Brazilian Food Insecurity Scale, which was included in the 2004 National Household Survey (PNAD). The history of the development of the scale in the U.S. and its validation in Brazil are described. Characterized as a direct measure of household food insecurity, this psychometric scale can be used together with indicators and measurement instruments from diverse fields to broaden understanding of this complex phenomenon.

Insegurança alimentar das famílias residentes em municípios do interior do estado da Paraíba, Brasil

OBJECTIVE: The objective of this study was to identify the prevalence of household food security in 14 municipalities of Paraiba State and examine its association with the social, demographic and economic profile of these families. METHODS: A cross-sectional study comprising 4,533 families was performed. A questionnaire was used to assess the sociodemographic characteristics together with the Brazilian Food Insecurity Scale. The prevalences were calculated and the association between the studied variables was verified by the chi-square test. A logistic regression model was adjusted to identify risk factors associated with food security and insecurity. RESULTS: The prevalence of food insecurity was 11.3% for severe, 17.6% for moderate and 23.6% for mild. Food security was found in 47.5% of the families. The situation in rural areas was worse than in urban areas. Insufficient money to buy food was the main reason reported for the food insecurity status. The final logistic regression consisted of three variables: low per capita family income (US

Violência doméstica na gravidez: prevalência e fatores associados

12.00 vs. US

Severe food insecurity is associated with obesity among Brazilian adolescent females

150.00, Odds Ratio=19.10), poor household conditions (Odds Ratio=1.98) and permanent absence of water supply (Odds Ratio=1.38). A lower prevalence of severe food insecurity was found among families with per capita monthly income up to US

Transferência de renda e segurança alimentar no Brasil: análise dos dados nacionais

12.00 that were included in social programs. CONCLUSION: The prevalence of food insecurity was high. The methodology used proved to be an important assessment tool of food security status and useful to monitor public policies such as the social programs that are part of the Fome Zero (Zero Hunger) strategy of the Federal Government.

Insegurança alimentar intrafamiliar e perfil de consumo de alimentos

OBJETIVO: Identificar los factores asociados a la violencia domestica contra gestantes. METODOS: Se entrevistaron 1.379 gestantes usuarias del Sistema Unico de Salud que frecuentaban las unidades basicas de salud en el municipio de Campinas (Sureste de Brasil). Se analizaron las primera y segunda entrevistas de un estudio de cohorte, aplicandose cuestionario estructurado sobre violencia domestica valido en Brasil, de julio de 2004 a julio de 2006. Se realizaron analisis descriptiva y regresion logistica multiple de los datos. RESULTADOS: Del total de las gestantes, 19,1% (n=263) reportaron violencia psicologica y 6,5% (n=89) violencia fisica/sexual. Los factores asociados a la violencia psicologica fueron: pareja intima adolescente (p<0,019) y gestante que ha presenciado agresion fisica antes de los 15 anos (p<0,001). Se asociaron a la violencia fisica/sexual: dificultad de la gestante para acudir a las consultas de pre-natal (p<0,014), pareja intima que hace uso de drogas (p<0,015) y no poseer empleo (p<0,048). Los factores asociados a la violencia psicologica y fisica/sexual fueron: bajo nivel de escolaridad de la gestante (p<0,013 y p<0,020, respectivamente), ser la gestante responsable por la familia (p<0,001 y p=0,017, respectivamente), gestante que ha padecido agresion fisica en la infancia (p<0,029 y p<0,038, respectivamente), presencia de trastorno mental comun (p<0,001) y consumo de bebida alcoholica, por parte de la pareja intima, dos o mas veces por semana (p<0,001). CONCLUSIONES: Se pudo constatar alta prevalencia de las diferentes categorias de violencia domestica practicada por la pareja intima durante el periodo gestacional, asi como, con los diversos factores asociados a las mismas. Mecanismos apropiados para la identificacion y abordaje de la violencia domestica en la gestacion son necesarios, especialmente en la atencion primaria.OBJECTIVE To identify the factors associated with domestic violence against pregnant women. METHODS Interviews were conducted with 1,379 pregnant women undergoing antenatal care in basic health care units of the Brazilian Health System, within the municipality of Campinas (Southeastern Brazil). A structured questionnaire on domestic violence, validated in Brazil, was applied between July 2004 and July 2006. The first and second interviews in a cohort study were analyzed. Descriptive and multiple logistic regression analysis of the data were conducted. RESULTS Psychological violence was reported by 19.1% (n=263) of the total sample of pregnant women and physical/sexual violence was reported by 6.5% (n=89) of them. The factors associated to psychological violence were: adolescent intimate partner (p<0.019) and the pregnant woman had witnessed physical aggression before she was 15 years old (p<0.001). The factors associated to physical/sexual violence were: difficulties encountered by the pregnant woman in attending her antenatal appointments (p<0.014), intimate partner uses drugs (p<0.015) and does not work (p<0.048). The factors associated to psychological and physical/ sexual violence were: low level of education of the interviewee (p<0.013 and p<0.020, respectively), the pregnant woman being responsible for the family (p<0.001 and p=0.017, respectively) pregnant woman had suffered physical aggression during childhood (p<0.029 and p<0.038, respectively), presence of common mental disorder (p<0.001) and intimate partner consumes alcoholic beverage twice or more weekly. (p<0.001). CONCLUSIONS A high prevalence of different categories of domestic violence by an intimate partner during pregnancy was found as well as different factors associated with them. Appropriate mechanisms are necessary, particularly in primary health care, to identify and deal with domestic violence during pregnancy.

Gender of respondent does not affect the psychometric properties of the Brazilian Household Food Security Scale

OBJECTIVE To determine whether household food insecurity (HFI) is associated with a higher prevalence of excessive weight (EW) in a large random sample of Brazilian female adolescents. DESIGN Nationally representative cross-sectional study. EW was the outcome variable (BMI ≥ 85th percentile of WHO reference for adolescents aged 15-18 years and BMI ≥ 25 kg/m(2) for those aged 19 years). HFI was measured with the Brazilian Food Insecurity Scale. Associations were measured using crude and adjusted prevalence ratios (PR) with 95 % confidence intervals through Poisson regression models taking into account the complex sampling design. SETTING Data were derived from the third wave of the Demographic and Health Survey conducted in 2006-2007, in Brazil. SUBJECTS The sample included 1529 female adolescents aged 15-19 years. RESULTS The prevalence of any level of HFI was 40.8 %, with 26.6 % of households experiencing mild, 9.4 % moderate and 4.8 % severe food insecurity. The overall prevalence of EW was 21.9 % (12.9 % were overweight and 9.0 % obese). EW prevalence among those living in severely, moderately and mildly food-insecure households was 36.8 %, 14.9 % and 16.5 %, respectively (P for the overall association = 0.036). Women living in severely food-insecure households had an increased prevalence of EW compared with their food-secure counterparts (PR = 1.96; 95 % CI 1.18, 3.27; P = 0.007), after adjusting for important confounders. CONCLUSIONS The study suggests that severe but not mild or moderate HFI is independently associated with EW among adolescents residing in Brazil, a middle-income country undergoing the nutrition transition.

Violence against pregnant women: prevalence and associated factors.

OBJECTIVE: The 2004 National Household Survey Data was analyzed to test the hypothesis that cash transference from government social programs is associated with household food security. METHODS: Secondary data were used from the National Household Sample Survey which interviewed residents of 112,716 households. The present analysis included permanent and temporary private households, where food security items were informed by a resident of the household, restricting the collection of data to households with per capita monthly income of up to 1 minimum wage, representing 51.2% of the sample. Three models for estimating the amount of cash transference were developed; model 3 was chosen because it was less likely to overestimate effects. To analyze how cash transference affected the prevalence of food security, only households that received cash transference were included in the analysis, representing 14.2% of the interviewed households. The association between food security and cash transference, controlled for other independent variables, was estimated using a logistic regression model with stepwise method for each of the three income strata. RESULTS: The mean per capita cash transference was of R